Finger defect reconstruction using the radial artery superficial palmar branch free flap

Purpose: The radial artery superficial palmar branch (RASP) free flap is accepted as a surgical technique for the reconstruction of finger defects. This study revisited the RASP free flap and evaluated its reliability and usefulness in a variety of finger defects.Methods: From January 2017 to December 2022, multiple surgeons at a single institution performed a total of 315 RASP free flap reconstructions. Basic patient demographics and information on the finger defect and flap were assessed, and immediate postoperative flap and donor site-related complications were also studied. Data regarding long-term outcomes, such as the thumb joint range of motion and static two-point discrimination (S2PD), were collected and evaluated to identify statistically significant differences from the unaffected or non-innervated side. Results: The mean postoperative follow-up was 14.8 months. The total flap survival rate was approximately 91.4%. There was no statistically significant difference in mean postoperative palmar abduction and radial abduction between the affected and unaffected thumbs in both groups. In the single-digit group, there was a statistically significant difference in S2PD between the innervated flap and unaffected side. A statistically significant difference was also found between innervated and non-innervated flaps in the multiple-digits group. Conclusion: The RASP free flap is a valuable surgical option in reconstructing finger defects. It has already been proven to be safe and useful in coverage of single and tip defects. Stability should be ensured when there are multiple defects. Finally, the donor site morbidity is minimal and the recovery of sensation, once the flap is reinnervated, could be promising.